Handling National Chain Competition by Learning How to Run a Business.

Dr. Ezekial (Zeke) Thomas has been in practice for 46 years. He is a small animal vet and works with exotics such as reptiles and birds. His father was a general veterinarian and, in 1960, Dr. Thomas went to work with his father at the practice. The elder Dr. Thomas retired in 1964 and moved to a fishing village in northern Florida and Zeke has been running it since.

Dr. Thomas had an unusual occurrence happen that prompted him to take on a practice management consulting firm. He found out that PetSmart, a large national chain, was going to be opening up about 700 feet away from his office. Numerous people told him that this would severely impact his practice and that he better do something about it. “They were an unknown,” said Dr. Thomas. “Many other vets in area also were concerned about the chain moving in and took unusual measures to prevent problems such as lowering vaccination charges.”

Dr. Thomas had been practicing veterinary medicine for over 30 years when the chain moved in. He had never used consultants before and was averaging $180,000 a year. But he knew he needed to do something, so he took the plunge and hired some outside help.

From the management skills he learned, he was not only able to retain his clientele and not lose them to the big chain, but also his production soared to over $500,000 a year in less than 3 years. And, again, at this point he had already been in practice for over 30 years, which makes this quite a remarkable change.

“The absolute biggest benefit I received from taking on a consulting firm was learning how to run a business,” explained Dr. Thomas, “Practicing veterinary medicine is one thing, running a business is another. They don’t teach you how to run a business in vet school That’s not why we were there. It didn’t make sense that some people did great coming out of school and others didn’t. The difference is what I learned through using consultants.”

Dr. Thomas has been married for 16 years to his second wife Susan and has two children from his previous marriage and two step-children. His greatest passion, aside from his family, is boating on the Gulf of Mexico. He has a 41-foot boat that he regularly takes out to help him unwind.

Dr. Thomas feels that anyone can handle any practice and cause it to grow, no matter the competition, no matter the demographics and no matter whether you are up against big chains like PetSmart, WalMart, etc. His experience shows that if you know how to properly run a business – including internal and external marketing, hiring and training staff, having proper office policies and job descriptions and financial systems in place, you can be successful. He knows this because he did it and feels that anyone could do the same.

Saliva as a Diagnostic Tool for Periodontal Disease

A University of Kentucky research study could help change the diagnosis and treatment of periodontal disease.

An article, “Salivary Biomarkers of Existing Periodontal Disease,” discusses the importance of saliva and its potential to be a diagnostic tool.

The study was conducted by a team of UK researchers to determine if saliva could be tested for signs of periodontal disease, a chronic bacterial infection affecting millions of Americans characterized by persistent inflammation, connective tissue breakdown and alveolar bone destruction. Results showed that saliva could be a significant component in diagnosing and monitoring periodontal disease.

“Our research team has been working on methods and point-of-care devices that could allow saliva to be used as a diagnostic fluid,” said Craig Miller, primary investigator and professor of oral medicine at UK. “Our initial emphasis is on the identification of biomarkers in saliva that will allow us to diagnose periodontal disease. We have made great strides in doing just that, as evident by our recent data published in JADA.”

“This could impact the practice of dentistry and medicine in the very near future, as health care practitioners use saliva, possibly instead of blood, to diagnose and monitor oral and systemic health. With time and continued research funding, we are hoping to realize portable devices that can diagnose a wide variety of disease conditions using saliva,” Said Dr. Miller.

In the March issue of the Journal of the American Dental Association, which was devoted to studies on the salivary glands, two feature stories and two editorials evaluated the future of saliva as a diagnostics tool. The second feature story was a study from the University of California – Los Angeles, which examines markers in saliva of patients that are correlated with oral cancer.

“Point of Care diagnostics is the holy grail for the health care in the 21st century,” said Daniel Malamud, professor at New York University, in his guest editorial, “Salivary Diagnostics: the Future is Now,” also appearing in the March issue of JADA. “Within the discipline of POC diagnostics the use of saliva and other oral samples as the source of biomarkers is particularly appealing since their collection is relatively noninvasive and well-tolerated by the patient.”

The authors of the UK study include: Miller, Mark Thomas, associate professor and chair, department of Oral Health Practice, UK College of Dentistry; Charles King, a periodontist in private practice in South Carolina; Chris Langub, scientific review administrator, office of public health research, Center for Disease Control and Prevention; and Richard Kryscio, UK professor of statistics and biostatistics

From University of Kentucky press release

Project Could Help Pets Serve As Disease Watchdogs

A national surveillance network that uses the medical records of companion animals could help prepare for a wide variety of emerging disease threats to humans and animals, including avian influenza, according to veterinary scientists at Purdue University’s School of Veterinary Medicine.

The National Companion Animal Surveillance Program was originally designed to alert people to potential anthrax or plague outbreaks. New findings on tests of the program are detailed in the current edition of Vector-Borne and Zoonotic Diseases, a medical journal that focuses on diseases transmitted to humans by vectors such as mosquitoes or directly from animals.

Larry Glickman, a professor of epidemiology in the School of Veterinary Medicine, designed the National Companion Animal Surveillance Program in collaboration with Banfield, The Pet Hospital, a nationwide chain of veterinary hospitals. Between 2002 and 2004, tests were conducted on more than 10 million pet records to determine how the database could be used to monitor disease outbreaks.

“We discovered we can use analytical techniques to target specific geographic areas where vaccines need to be developed,” Glickman said. “This early warning will become critical to stop the spread of avian flu virus and other diseases that might affect humans. The quicker we can identify the problem in the more than 150 million dogs, cats or pet birds that live in approximately 40 percent of all households in the United States, the greater the probability we can contain a disease before it spreads to humans.”

Authors of the research paper were Glickman; George E. Moore, Nita W. Glickman and Richard J. Caldanaro of Purdue’s School of Veterinary Medicine; David Aucoin of VCA Antech; and Hugh B. Lewis of Banfield, The Pet Hospital.

Researchers collected data from 80,000 companion animals treated weekly at more than 500 Banfield hospitals in 44 states. Additional data included reports from VCA Antech Diagnostics, a nationwide network of laboratories used by more than 18,000 private veterinary practices.

Medical records were transferred to Purdue, where they were stored and converted for analysis with the help of COMSYS Information Technology Services, a consulting firm located in Houston.

Based on the data, researchers found:

o A clear pattern of association between flea and tick infestation in pets compared to the incidence of Lyme disease in humans, with a two-month lag and peak rates occurring during warmer months. This information allows veterinarians to anticipate unusual occurrences of diseases that are transmitted from animals to humans and design treatment methods. Public health officials also could be alerted so they could provide timely information to the public and spray affected areas for ticks. In addition, specimens such as these can be used for profiling a broader variety of diseases that are potentially transmitted to humans by fleas and ticks, such as Rocky Mountain spotted fever.

o A 3.3 percent increase in the number of positive tests from 2002-2004 for a disease called canine leptospirosis. Leptospirosis can be transmitted from dogs to humans. The disease is currently the leading cause of acute kidney failure in dogs and also can damage the liver. Most animals and humans recover from leptospirosis if it is diagnosed early and treated with antibiotics. This research will help develop early warning signs and aid in the development of vaccines that target emerging new strains of leptospirosis. The data also documents an increase in the disease over the past 10 years, probably related to increasing contact between dogs and wildlife such as raccoons, Glickman said.

o A correlation between the number of cases of influenza-like illness in cats and similar symptoms in humans in the Washington, D.C., area where Banfield has numerous hospitals. This pattern suggested common environmental causes of influenza in cats and people. The finding illustrates the importance of the ability of Purdue researchers to track diseases by geographic area and to detect statistical clusters of events in companion animals that could signal the introduction of new viruses into the United States, such as avian influenza virus due to bird migration or bioterrorism.

“We wanted to show that these animals could be used as sentinels of infectious agents and perhaps predict the occurrence of diseases in humans,” Glickman said. “The long-term goal is to partner with other providers of companion animal health care and animal laboratory data to create a comprehensive system that will be a national resource to further the practice of evidence-based veterinary medicine and veterinary public health. We think there is no comparable human-surveillance system in the country.”

In ongoing work, the Purdue researchers are investigating ways to monitor cats for avian influenza. In collaboration with Banfield, they have developed an early-warning system for the occurrence of canine influenza that is caused by a virus that appears to have jumped recently from horses to dogs. If a dog comes to a Banfield clinic with a predetermined set of clinical signs, the computer screen flashes in the hospital and information appears that advises the practitioner what samples to collect from the dog for virus identification. A similar real-time surveillance system could be used to identify the avian influenza virus in pet birds or cats, Glickman said.

“The avian flu virus could be the ‘black plague’ of veterinary medicine, but we can be proactive through early detection and vaccine development,” Glickman said. “A reporting system such as this for companion animals will allow us to educate veterinarians and help the public. It also will demonstrate what is possible in human medicine with development of a more centralized and coordinated health-care delivery system.”

The research was funded in part by the Centers for Disease Control and Prevention.

Writer: Maggie Morris

Sources: Larry Glickman

Purdue School of Veterinary Medicine

From: Purdue University, Medical News Today

Who Does What:

Confusion About Eye Care Providers, Training, M.D. Status

Survey Highlights Need for Education; Consumer Group Offers Tips, White Paper

A survey commissioned by the National Consumers League finds that when it comes to eye care, many consumers – in Oklahoma and across the United States — are uncertain about the differences among various eye care providers, the services they perform, and the training and education they must complete. Despite the confusion about eye care
professionals, consumers have strong opinions on the need for a medical degree: when it comes to performing surgeries (including laser), injecting/prescribing medications, and emergency care, most respondents indicated that they would prefer their eye care provider to have a medical degree.

The National Consumers League, the nation’s oldest consumer advocacy organization, commissioned the survey in order to explore consumers’ understanding of eye care providers. Survey highlights include:

  • Many consumers, including those who wear glasses or contact lenses, are uncertain about the differences among various eye care providers, the services they perform, and the training and education they must complete.
  • Fully one-third of respondents incorrectly thought optometrists are medical doctors.
  • When asked hypothetically about the type of eye care provider a respondent would see if they suffered from advance eye conditions, respondents showed an overwhelming preference to visit an ophthalmologist for their eye care.

The survey also included specific findings in Oklahoma, the only state that allows optometrists to perform certain laser and scalpel surgery:

  • In Oklahoma alone, 99 percent of consumers surveyed thought they should be told whether their eye care provider is a trained and licensed medical doctor before receiving eye care treatment.
  • Oklahoma consumers showed a strong preference for ophthalmologists when asked whom they prefer to see for advanced eye conditions.
  • Oklahomans strongly agreed (94%) that patients should have the right to insist that their eye surgery be performed by a trained and licensed medical doctor.

“When it comes to eye care, it is vital for consumers to understand who can provide what kind of services and to have a clear understanding of the education and training of the eye care professional,” said NCL President Linda Golodner. “There are a number of different types of professionals on the eye care team, and unfortunately, many consumers, as seen in our survey, don’t differentiate among them. As in any aspect of health care, consumers must take an active role and familiarize themselves with those from whom they are
seeking treatment.”

The eye care arena is often confusing to consumers due to the number of professionals who offer services.

  • Ophthalmologists are medical doctors who specialize in all aspects of eye care. They provide primary eye care services (eye exams and prescribing glasses and contacts) and diagnose and treat eye disease and injuries, as well as perform eye surgery. Ophthalmologists must complete four years of medical school, a one-year internship, and three years of residency.
  • Optometrists provide most routine, primary vision care. They examine the eye to diagnose vision problems and diseases. They prescribe contact lenses and glasses, and prescribe and administer some medications. Optometrists earn a Doctor of Optometry after four years of optometry school.
  • Opticians dispense and fit contact lenses and glasses. Opticians have earned either an associate opticianry degree or apprenticed for two years.

To help consumers better understand eye care, NCL has created new Web resources and tips at its Web site, At the site, consumers can learn about the various members of the eye care team, their training and the services they can provide. It also includes tips and a checklist of questions for patients to ask their eye care providers about treatments and services. NCL has also produced a white paper about the state of eye care in the United States. To learn more, visit

The Web-based survey of 600 adults over the age of 25 was conducted for NCL by TNS J Street, a Washington-based survey firm. A total of 600 respondents from the NFO Chronic Ailment Panel (CAP) participated in a 20-minute online survey from July 22-27, 2005. Of the 600 respondents, 500 proportionally represented 49 states, and 100 were sampled from Oklahoma. The survey was conducted at a 5 percent risk level, or 95 percent level of confidence. The survey was made possible by an unrestricted educational grant provided by the American Academy of Ophthalmology.

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad.

For more information, visit

From PR Newswire

Boom in Baby Boomer Eye Disease Anticipated

Optometrists Anticipate ‘Boom’ in Eye Diseases as Baby Boomers Turn 60 – Save Your Vision Month Promotes Regular Eye Exams

In a year where an estimated 2.8 million baby boomers will celebrate their 60th birthday, age-related eye diseases are becoming increasingly important health issues, according to the American Optometric Association (AOA). The AOA is reminding Americans 60 and older that early detection through a comprehensive eye exam can prevent or slow vision loss due to cataracts and other age-related eye diseases such as macular degeneration, glaucoma and diabetic retinopathy.

“Today’s 60-year-olds are more health conscious than 60-year-olds 20 years ago,” said Richard C. Edlow, O.D., American Optometric Association Information and Data Committee chair. “But being better informed about health risks, improved technology and treatment options has not necessarily translated into including regular eye examinations into their health care routine.”

The National Eye Institute estimates that over the next 30 years, the current number of blind or visually impaired Americans will double because of aging baby boomers. According to the AOA, 20.5 million people age 60 and over have cataracts, a leading cause of poor vision in the United States.

“Age-related eye diseases do not have to lead to vision loss or blindness,” Dr. Edlow said. “Some of these have no symptoms in the early stages, which is when it is most critical to help slow the progression of vision loss.”

A comprehensive eye examination provides doctors of optometry with information about the health of the eyes, and also offers indications about diseases that affect the whole body, like diabetes and hypertension.

“Many people don’t understand that even though their vision may be clear, exams can uncover changes in the eye caused by high blood pressure, diabetes, retinal disorders and glaucoma,” said Dr. Edlow. “Since there are more treatment and rehabilitation options than ever before, early detection is all the more critical.”

The American Optometric Association represents more than 34,000 doctors of optometry, optometry students and paraoptometric assistants and technicians. Optometrists provide more than two-thirds of all primary eye care in the United States and serve patients in nearly 6,500 communities across the country. In 3,500 of those communities they are the only eye doctors.

Eye Fungus Reports Increase as Cases Emerge in United States

American Optometric Association Urges Americans to Take Proper Contact Lens Precautions to Protect Against ‘Fusarium Keratitis’

Doctors of optometry from the American Optometric Association’s (AOA) Contact Lens and Cornea Section urged contact lens wearers to take proper precautions amid reports of a potentially sight-threatening eye fungus appearing in the United States with increased frequency.

U.S. health officials are on alert after a recent outbreak of severe corneal infections associated with contact lens wearers in Asia began surfacing in America. The New York State Department of Health has issued an alert in collaboration with the New Jersey Department of Health and Senior Services and the Centers for Disease Control and Prevention, acknowledging that they are investigating three cases of Fusarium keratitis, a severe corneal fungal infection that has recently been linked to soft contact lens use. Optometrists in Florida and Iowa also have reported seeing similar cases in patients.

“This recent news is cause for concern, but not for alarm,” said Jack Schaeffer, O.D. and chair-elect of the Contact Lens and Cornea Section of the AOA. “We want our patients to be aware that there is a problem out there and that the details are unfolding as we speak. We remain committed to protecting the eye health of Americans throughout this situation.”

Health officials have not yet determined whether the cases in the United States are directly related to outbreaks in Asia. Treatment for Fusarium keratitis includes anti-fungal medication. However, some patients have reportedly experienced a significant loss of vision, resulting in the need for a corneal transplant.

“We want to make sure Americans are taking the necessary precautions to protect themselves in this interim period as information becomes available,” said AOA President Richard L. Wallingford, O.D. “It is imperative that contact lens users practice safe handling of their contact lenses, are aware of any potential vision problems and alert their optometrist as they occur.”

Doctors of optometry urge anyone who experiences the following symptoms to contact their optometrist immediately:

  • Sudden blurred or fuzzy vision
  • Red and irritated eyes lasting for an unusually long period of time
  • Pain in and around the eyes
  • Increased sensitivity to light
  • Excessive eye tearing

From PR Newswire

Clinical Test for Saliva-based Oral Cancer Detection Ready

Oral cancer is the 6th most common cancer in men and the 14th most common cancer in women. In the US, oral cancer will be diagnosed in an estimated 30,000 Americans this year and will cause more than 8,000 deaths. The disease kills approximately one person every hour. Oral cancer can spread quickly. The majority of oral cancers are diagnosed in late stages, which accounts for the high death rates. Only half of those diagnosed with the disease will survive more than five years. However, if the cancer is detected early, there is an 80 to 90% chance for survival. It is therefore extremely important to detect oral cancer as early as possible, when it can be treated more successfully, thus enhancing the rate of survival.

Currently, the early detection of oral cancer depends on a thorough oral cancer examination, usually by a dentist or other qualified health care provider, for possible signs and symptoms of this disease. Scientists are working on technologies and biomarkers for the early detection of oral cancer. Saliva, an easy-to-obtain and non-invasive body fluid, has recently been shown to harbor highly informative biomarkers for oral cancer detection. Scientists in Dr. David Wong’s laboratory at the School of Dentistry at UCLA have discovered that seven RNAs, molecules that carry information in cells, when found in saliva are very useful for oral cancer detection. The saliva oral cancer RNA signature has been tested in over 300 saliva samples from oral cancer patients and healthy people, and the signature is always present in higher levels in the saliva of oral cancer patients than in saliva from healthy people, with an overall accuracy rate of about 85%.

The next important step was to turn these scientific findings into clinical tests that can be used for early oral cancer detection. Wong’s research team reported at the 35th Annual Meeting of the American Association for Dental Research for the first time that they have developed a standardized “Saliva RNA Test for Oral Cancer” ready for clinical usage.

The “Saliva RNA Test” has been tested in 100 oral cancer and healthy people, and it has been confirmed that four saliva oral cancer RNA biomarkers are highly accurate in detecting oral cancer, at around 82%. This is the first standardized saliva-based test for clinical oral cancer detection and will have enormous clinical value in reducing the mortality and morbidity for oral cancer patients, as well as improving their quality of life.

In a related study, further illustrating the importance of saliva as a diagnostic tool, scientists at the National Institute of Dental and Craniofacial Research (NIDCR), one of the Federal Government’s National Institutes of Health (NIH), have studied the protein profile in the saliva of patients with Sjögren’s syndrome, an autoimmune disorder in which the immune system cells attack the saliva- and tear-producing glands, causing them to become inflamed. Patients suffer from constant dryness of the mouth and eyes, as well as many other systemic problems. In this recent study, the scientists analyzed saliva from patients with and without Sjögren’s syndrome to find out whether the amounts and types of salivary proteins differed. They found that saliva from the patients with Sjögren’s has both increased amounts of proteins related to inflammation and a decreased amount of proteins produced by salivary glands. Future studies are planned to determine whether these protein levels could be useful in diagnosing Sjögren’s syndrome.


This is a summary of abstract #218, “Salivary Oral Cancer Transcriptome Biomarkers (SOCTB) for Clinical Detection”, by J. Wang, S. Henry, T. Yu, Y. Li, D. Elashoff, M. Oh, K.-C. Li, X. Wei, and D. Wong (UCLA), and abstract #219, “Salivary Biomarkers in Parotid Saliva of Sjögren’s Syndrome”, by J.C. Atkinson, O. Ryu, G. Hoehn, G. Illei, and T. Hart (NIDCR/NIH, Bethesda, MD), to be presented at 11:30 a.m. and 11:45 a.m., respectively, on Thursday, March 9, 2006, in No. Hemisphere A-1 of the Walt Disney World Dolphin Hotel, during the 35th Annual Meeting of the American Association for Dental Research.

US Prepares for Highly Pathogenic Avian Flu in Wild Birds

Avian Influenza (AI) — the bird flu — is a disease caused by a virus that infects domestic poultry and wild birds (geese and ducks and shorebirds). Each year, there is a bird flu season just as there is for humans and, as with people, some forms of the flu are worse than others.

The highly pathogenic H5N1 strain of bird flu has been found in an increasing number of countries in Europe, Asia and Africa. Currently, H5N1 avian influenza is not present in the United States. It is likely the highly pathogenic H5N1 strain will spread to this country, and the U.S. Government is taking steps to prepare for and minimize the potential impact of bird flu.

There are a number of ways that highly pathogenic H5N1 could potentially reach the United States — wild bird migration, illegal smuggling of birds or poultry products, travel by infected people or people traveling with virus-contaminated articles from regions where H5N1 already exists.

Historically, highly pathogenic strains of avian influenza have been detected in domestic poultry populations three times in the United States: in 1924, 1983 and 2004. There have been no occurrences of highly pathogenic avian influenza in wild birds in the United States and no significant human illness resulted from any of these outbreaks.

  • The 1924 H7 outbreak was contained and eradicated in East Coast live bird markets.
  • The 1983-84 H5N2 outbreak resulted in the destruction of approximately 17 million chickens, turkeys and guinea fowl in the northeastern U.S. to contain and eradicate the disease.
  • In 2004, USDA confirmed an H5N2 outbreak in chickens in the southern United States. The disease was quickly eradicated thanks to close coordination and cooperation between USDA, state, local and industry leaders. Because of the quick response, which included quarantine and culling of birds, the disease was limited to one flock.

Monitoring Bird Health in the U.S.

The U.S. Department of the Interior and U.S. Department of Agriculture have proactive interagency efforts underway to monitor wild migratory birds in the United States and to test statistically significant samples of populations of various migratory bird species for avian influenza.

USDA and Interior’s agencies, including the U.S. Geological Survey and the U.S. Fish and Wildlife Service, have been working for the past several months with State of Alaska biologists to strategically sample live birds, hunter-taken birds, sentinel flocks, and the environment used by these targeted populations for highly pathogenic H5N1 bird flu in the Pacific Flyway. The Interagency Strategic Plan for monitoring of wild birds, which expands and intensifies their program in 2006, focuses on this Alaska area because it is a flyway crossroads for migratory birds that annually return from their winter migration in Asia, and come in contact with other North American migratory birds that return to Alaska in the spring from wintering areas in the southern United States and Central America.

Testing also is being carried out in other migratory bird flyways in cooperation with state and local agencies. This enhanced monitoring program will provide an early warning to the agriculture, public health and wildlife communities should migratory birds be found to carry the highly pathogenic H5N1 virus.

Since 1998, USDA and the University of Alaska have tested more than 12,000 wild migratory birds in AK and since 2000 USDA and the University of Georgia have tested more than 4,000 wild birds in the Atlantic flyway. All birds tested negative for highly pathogenic H5N1. As part of this enhanced monitoring, in 2006 USDA, DOI and its cooperators plan to test between 75,000 to 100,000 samples from live and dead birds. Eleven thousand of the live bird samples will be initially screened by USGS at its Nat’l Wildlife Health Center in Madison, WI. The remaining samples will be initially tested at labs certified by USDA in the National Animal Health Laboratory Network. Suspected findings of highly pathogenic avian influenza will be further tested and diagnosed by the USDA National Veterinary Services Laboratory lab in Ames, Iowa.

USDA’s Animal Plant Health Inspection Service (APHIS) and Interior’s Fish and Wildlife Service also works with the U.S. Department of Homeland Security’s U.S. Customs and Border Protection at major U.S. air and seaports to inspect, examine and regulate the importation of live poultry, commercial birds, pet birds and/or “hatching eggs.” Interior land management agencies, including the National Park Service, FWS, Bureau of Land Management, Bureau of Indian Affairs and Bureau of Reclamation, are educating their employees and working with stakeholder and support groups, and preparing protocols to protect visitors and employees on public lands. (Many of these lands provide nesting, migration and wintering habitat for waterfowl and other migratory birds. More than 450 million people visit Interior lands annually.) Interior also has developed a departmental pandemic influenza plan to assure continuity of operations.

In addition, USDA monitors U.S. domestic and wild bird populations. Monitoring is conducted in four key areas: live bird markets, commercial flocks, backyard flocks and migratory bird populations. Frequent testing occurs in live bird markets and commercial flocks. Additionally, birds are tested that show signs of illness. To help backyard and smaller poultry producers, the USDA “Biosecurity for the Birds” program provides important information about reducing the chances of birds becoming infected with AI. Biosecurity refers to the application of practical, common sense management practices to keep AI and other poultry diseases out of our commercial and backyard flocks.

In the event of a highly pathogenic avian flu outbreak in the United States, USDA maintains a bank of bird vaccines to protect healthy birds outside a quarantine area, if necessary. The vaccine would be used to create a firewall around a quarantine to prevent spread. Currently, USDA has 40 million available bird vaccine doses, which have been proven effective against the highly pathogenic H5N1 virus. Another 70 million doses are in development. USDA works closely with its federal, state and tribal partners, as well as

industry stakeholders to ensure that effective and coordinated emergency response plans are ready should an outbreak HPAI occur. In addition, USDA researchers are developing faster diagnostic tests, enhanced vaccines for birds and new information about how avian influenza spreads so that the United States is better prepared for avian influenza outbreaks.

Bird Import Restrictions

As a primary safeguard, USDA maintains trade restrictions on the importation of poultry and poultry products from countries where the H5N1 HPAI strain has been detected in commercial or traditionally raised poultry, not in wild or migratory birds. Additionally, USDA has increased its monitoring of domestic commercial markets for illegally smuggled poultry and poultry products. All imported live birds must be quarantined for 30 days at a USDA quarantine facility and tested for the avian influenza virus before entering the country. Home quarantine and testing for AI also is required for returning U.S.-origin pet birds. The U.S. Fish and Wildlife Service works with USDA to communicate these trade restrictions to the pet bird trade community and incorporates them into decisions on permits it issues for wild bird trade.

Guidance for handling wildlife

The Department of Interior’s National Wildlife Health Center has issued guidance to follow routine precautions when handling wild birds. The Center recommends that people handling wild birds:

  • Do not handle birds that are obviously sick or birds found dead.
  • Wear rubber or disposable latex gloves while handling and cleaning game, wash hands with soap and water (or with alcohol-based hand products if the hands are not visibly soiled), and thoroughly clean knives, equipment and surfaces that come in contact with game.
  • Do not eat, drink, or smoke while handling or cleaning birds.
  • Cook all game meat thoroughly (at least to 1650° F) to kill disease organisms and parasites.

Monitoring Human Health

At present, highly pathogenic avian influenza, such as the highly pathogenic H5N1 strain, is a disease of birds and is not readily transmitted to humans. In rare cases, it can be spread from birds to people primarily as a result of extensive direct contact with raw infected poultry or poultry droppings. There have been no documented cases of human highly pathogenic H5N1 disease resulting from contact with wild birds.

Broad concerns about public health relate to the potential for the virus to mutate, or change into a form that could spread from person to person. The U.S. Department of Health and Human Services is aggressively working with a team of federal, state and industry partners to ensure public health is protected.

Since February 2004, HHS’ Centers for Disease Control and Prevention (CDC) has provided U.S. public health departments with a series of alerts providing recommendations for enhanced monitoring for highly pathogenic H5N1 influenza in the U.S. Distributed through CDC’s Health Alert Network, these alerts reminded public health departments about recommendations for detecting, diagnosing, and preventing the spread of highly pathogenic H5N1 virus. The alerts also recommended measures for laboratory testing for suspected highly pathogenic H5N1 virus.

Food Safety

Eating properly handled and cooked poultry is safe. If highly pathogenic H5N1 were detected in the U.S., the chance of infected poultry entering the human food chain would be extremely low. Even if it did, proper cooking kills this virus just as it does many other disease organisms and parasites. Poultry products imported to the U.S. must meet all safety standards applied to foods produced in the U.S.

  • Wash hands with warm water and soap for at least 20 seconds before and after handling food;
  • Prevent cross-contamination by keeping raw meat, poultry, fish, and their juices away from other foods;
  • After cutting raw meats, wash cutting board, knife, and counter tops with hot, soapy water;
  • Sanitize cutting boards by using a solution of 1 teaspoon chlorine bleach in 1 quart of water; and
  • Use a food thermometer to ensure food has reached the safe internal temperature — in all parts of the bird. Cook poultry to at least 1650 F to kill foodborne germs that might be present, including the avian influenza virus.

Planning for Pandemic Influenza

Should highly pathogenic H5N1 arrive in the U.S., it does not signal an influenza pandemic. Nonetheless, the HHS has been preparing for pandemic influenza for several years. Ongoing preparations include the following:

  • Working with the World Health Organization (WHO) and with other nations to help detect human cases of bird flu and contain a flu pandemic, if one begins
  • Supporting the manufacturing and testing of influenza vaccines, including finding more reliable and quicker ways to make large quantities of vaccines
  • Developing a national stockpile of antiviral drugs to help treat and control the spread of disease
  • Supporting the efforts of federal, state, tribal, and local health agencies to prepare for and respond to pandemic influenza
  • Working with federal agencies to prepare and to encourage communities, businesses, and organizations to plan for pandemic influenza

Each individual and family should know both the magnitude of what can happen during a pandemic outbreak and what actions can be taken to help lessen the impact of an influenza pandemic on themselves and their community.

To plan for a pandemic:

  • Store a supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.
  • Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
  • Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
  • Volunteer with local groups to prepare and assist with emergency response.
  • Get involved in your community as it works to prepare for an influenza pandemic.

To limit the spread of germs and prevent infection:

  • Teach your children to wash hands frequently with soap and water, and model the correct behavior.
  • Teach your children to cover coughs and sneezes with tissues, and be sure to model that behavior.
  • Teach your children to stay away from others as much as possible if they are sick. Stay home from work and school if sick.

Knowing the facts is the best preparation. Identify sources you can count on for reliable information. If a pandemic occurs, having accurate and reliable information will be critical.

  • Reliable, accurate, and timely information is available at
  • Another source for information on pandemic influenza is the Centers for Disease Control and Prevention (CDC) Hotline at: 1–800-CDC-INFO (1-800-232-4636). This line is available in English and Spanish, 24 hours a day, 7 days a week. TTY: 1-888-232-6348. Questions can be e-mailed to
  • Look for information on your local and state government Web sites. Links are available to each state department of public health at
  • Listen to local and national radio, watch news reports on television, and read your newspaper and other sources of printed and Web-based information.
  • Talk to your local health care providers and public health officials.

Additional Information

For more information about avian influenza:

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from: PRNewswire

Setting and Attaining Goals

The Targeting of Production

A very important aspect of group coordination and leadership is providing the staff with goals that are real to them and that they feel are attainable. In order to raise the production to the range you desire, the targets (both monthly and weekly) must be stated and “kept alive” with the staff.

Following is a suggested method of doing this:

As close to the beginning of the month as possible, sit down with your staff and go over the preceding month’s statistics, discussing very specifically what was done that created the production, new patients and collections (or lack thereof).

You would take into consideration the number of days worked, the promotional actions which were being done (or not done), the types of services which were being delivered or promoted and any problems (or successful actions) which occurred during the month.

To set the goal for the new month, you would look at the number of days that you are going to be working in the new month. You would look at the appointment book and determine what you have “on the books” so far. You would take a look at what types of promotional actions you have already planned (or are presently in progress). You would then consider what a realistic target would be for the new month, taking into consideration what the practice really can do and very importantly, picking a figure that is UP from the preceding month.

It is then extremely helpful for the staff to be given weekly and daily production targets that will be needed to make the overall goal. This will help them to stay focused toward “production booking”. They know exactly what must be produced to reach the goal by the end of the month.

You can then monitor the progress toward that goal by making a graph that statistically lays out the overall production goal and allows you to plot the actual production as it occurs. This could be done for weekly and monthly goals and for all individual production goals. (See example graph).

Setting and Attaining Goals

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How a Doctor Made his Wife Happy

Dr. Dirk Beyer, an optometrist based in Hamilton, Montana had no idea how much he didn’t know when he came out of optometry school.

“I had no idea how to run a practice,” said Dr. Beyer.

After graduating from the University of Houston College of Optometry in 1996, Dr. Beyer started his residency working for a government agency – the Indian Health Services. Granted, it gave a tremendous amount of hands-on experience on the clinical side, but it did nothing to prepare him for the real task of running a for-profit practice.

In 2000, after 4 years with Indian Health Services, Dr. Beyer bought a practice of his own. Initially there were 3 doctors and they went through 22 staff in a two-year period! There were no real management systems in place to properly run the business side of the practice.

After two years of struggling, he knew he needed some help. He hired a practice management consulting firm and quickly made remarkable improvement.

“I went from $353,000 in production per year to $750,000 per year in just over a 2-year period,” said Dr. Beyer. “I’m more organized and handling staff is a lot better and a lot easier.”

“We use statistics to keep us in line. Our scheduling is better, recall is better. The whole practice atmosphere has improved,” explained Dr. Beyer. “I would propitiate to staff or with clients if they didn’t get good service and I would give service away. Consulting got the practice to the point where I’m just the doctor and the staff take care of handling clients. It’s an incredibly successful formula. We handled things across the boards as well as got rid of a lot of bad management habits.

“We are excellent at pediatrics, filling contact lens prescriptions and educating our patients. These have all contributed to our big referral base.”

With this success, Dr. Beyer was able to purchase a new building with all new equipment and hired some new staff for expansion. He said, “A key aspect of consulting is getting new staff trained and operational.”

“Even given the success of the practice, I maintain consulting because it’s easy to wander off and do poorly. It enables me to stay on track even though we’re doing very well.”

He feels, though, that the biggest benefit has not been financial or organizational. The biggest benefit has been that his wife is now sleeping at night. Things used to be so stressful that his wife, Terri – his high school sweetheart – couldn’t sleep at night. Now she is happy and they have been able to have 3 children over the last 6 years.

His favorite hobbies are bow hunting, golf, snowboarding and skiing. “That’s why I love Montana, there are so many opportunities to do those activities,” exclaimed Dr. Beyer.

“I would like to add one more thing,” said Dr. Beyer, “Just because a practice has been in existence for many, many years doesn’t mean the doctor or the staff are doing well. It could just be they have been making the same mistakes over and over again for years. Consulting can help you to see the areas you’re blind to so you can recover and cause your production to go even higher.”